Lee Sanglim, Kim Min Bom, Lee Young Ho, Baek Jeong Kook, Baek Goo Hyun
From the *Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University; and †Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Ann Plast Surg. 2015 Sep;75(3):319-22. doi: 10.1097/SAP.0000000000000116.
Soft tissue and bone defects of the lower leg, ankle, and heel region often require coverage by local or distant flaps. The authors successfully used the distally based adipomuscular abductor hallucis flap for the treatment of 7 patients with soft tissue defect on the plantar forefoot after diabetic ulcer (n = 2), excision of melanoma at the medial forefoot (n = 3), and posttraumatic defects of the plantar forefoot (n = 2). The size of the defects ranged from 6 to 36 cm. All defects were covered successfully without major complications. The distally based adipomuscular flap from the abductor hallucis muscle provides a reliable coverage for small and moderate defects of the plantar and medial forefoot. This flap is often preferable to the use of free flaps because the surgery is rapidly performed and does not require microsurgical expertise.
小腿、踝关节及足跟区域的软组织和骨缺损通常需要采用局部或远处皮瓣进行覆盖。作者成功应用以远侧为蒂的拇展肌脂肪肌皮瓣治疗了7例患者，其中2例为糖尿病溃疡后前足跖侧软组织缺损，3例为前足内侧黑色素瘤切除术后，2例为前足跖侧创伤后缺损。缺损大小为6至36厘米。所有缺损均成功覆盖，无重大并发症。来自拇展肌的以远侧为蒂的脂肪肌皮瓣可为前足跖侧和内侧的中小缺损提供可靠的覆盖。该皮瓣通常比游离皮瓣更可取，因为手术操作迅速，且不需要显微外科专业技术。
